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Five Common Rules People With PTSD Tend to Follow

Trauma happens when we are rendered helpless, unable to avoid or stop the inevitable from occurring. This complete loss of control is horrifying and results in a very primitive physiological state that is designed to help us maximize our survival. Following a trauma, if our bodies are unable to regain a sense of safety, return to an optimal state of arousal, and reconnect with others, we may develop PTSD.


In an effort to regain a sense of safety, those with PTSD may create rules for themselves to follow in order to help them feel more in control – to make them think they can prevent bad things from happening again. These rules are intended to help them avoid perceived danger, emotional distress, and uncomfortable physiological states. Though following these sets of rules may give the PTSD sufferer the illusion of safety, they do not increase their actual safety. When their behaviour is guided by these rules, they may experience temporary relief, but they actually reinforce the feeling of danger and the need to remain vigilant. Worse still, their lives become narrowed by these rules and can worsen feelings of aloneness, disconnectedness, and despair.


Individuals who are diagnosed with PTSD all follow a set of rules. Though these rules differ depending on a unique set of personal factors, there are some very common rules that people with PTSD follow:




1. I need to avoid public places and crowds of people


A crowd that people with PTSD may avoid

Many people with PTSD experience extreme distress when surrounding by others. For example, grocery store visits, concerts, and restaurant dinners become incredibly uncomfortable, especially during peak busy hours. In these situations, individuals with PTSD may experience physiological shifts such as increased muscle tension, alertness, vigilance, perspiration, and stomach tightening. Emotionally, they may feel nervous, worried, fearful, or agitated. In terms of behavioural changes, many might find themselves scanning their environment in an attempt to identify and prepare to deal with a threat. They become particularly focused on the behaviour or facial expressions of others, the flow of traffic, or the layout of the environment in anticipation of something bad happening.


This all takes an incredible toll on the body, rendering a simple trip to the store for milk a completely exhausting and overwhelming event. However, for individuals with PTSD, the vigilance feels necessary in the off chance something threatening occurs.


As a result, the “avoid crowded places rule” is developed. For the PTSD sufferer, this rule serves two important purposes. First, it guides them away from what they perceive to be a dangerous situation. Second, it helps them avoid the distress that automatically occurs when they are in that situation.


So how does this rule play out in real life? Those with PTSD are often very selective about when they run their errands. They go during non-peak hours and take advantage of services such as click & collect, take out, and home delivery. They become selective about where they venture out to, often opting to carry out their business at smaller stores or those outside of town. Finally, they may limit their outings to only those that are necessary, completely cutting out previously enjoyed events such as live music, sporting events, or social gatherings.



2. When in a crowded place I must position myself so that my back is against the wall


Placing back against wall at a restaurant

This is a sub-rule of the first. The PTSD sufferer has established the belief that crowded places are more dangerous and must be avoided. However, there are certain responsibilities, obligations, and demands of life that necessitate travel to crowded areas. When the individual with PTSD is unable to avoid a crowded place, they often follow mini rules to help them feel safer within that place. Remember they tend to scan their environment? This is much easier to do when they have a full view of the environment in front of them. It also allows them to focus more intently on what is in front of them if they do not have to worry about what might also be behind them. This rule gives those with PTSD the illusion that they are safer because they believe they are better prepared to react should something dangerous occur.


How does this rule play out in real life? Those with PTSD may ask to be seated in a booth at a restaurant so that they can have their backs against the wall. They may stand sideways in a lineup in order to have a sideview of all those in front and behind them. They may select seating in the very back row of a theatre or sporting event.



3. I must stay busy


Staying distracted via cleaning

For those with PTSD, intrusive thoughts and memories of the trauma become more prevalent in moments of stillness and quiet. Anticipation of trauma memories make rest, relaxation, and sleep highly stressful. The rule, “I must stay busy” serves to occupy the minds of those with PTSD. Busying the body and occupying the mind is a distraction from the pain of trauma.


How does this rule play out in real life? Staying busy might look like constantly tinkering on small projects, cleaning, or organizing. It may mean endless scrolling on the internet or always having music on in the background. Those with PTSD may keep the television on to fall asleep. In more extreme ways, keeping busy through distraction might include promiscuous sexual activity, excessive spending, increased substance use, gambling, or other risky behaviours



4. I must not trust anyone



Establishing trust with another person

Trust inherently involves relinquishing some degree of control. Depending on the context, trust might involve revealing personal information such as what moves you, what hurts you, and what you desire most in life. For most of us, we offer that information to others because we believe it will help us meet our needs. But for those with PTSD, they believe that revealing that information puts them in a vulnerable place which will lead to getting hurt or being taken advantage of.


Besides revealing personal information, trust might involve delegating responsibility to others. For instance, it might involve relying on others to drive you to work and get you there on time, return a favour, or complete a necessary task (such as shovelling and salting the driveway). For the majority of people, relying on others helps us meet the demands in our lives and therefore alleviates our stress. However, for those diagnosed with PTSD, relying on others can create excessive worry and anticipation of the “other shoe dropping”


How does this rule play out in real life? People with PTSD may keep themselves at an emotional distance from others. Discussion may remain superficial or they may significantly limit their social engagement all together. Intimacy may be reduced (both emotional and sexual) despite feeling alone. They may feel the need to be in control of everything around them, overextending themselves and being reluctant to accept help. They may increase security at their homes, double check locks, and create rules for where personal items should be stored. Though it produces a false sense of control and preparedness, some individuals with PTSD might feel it necessary to be observant and skeptical of others behaviour.



5. I must not make mistakes


Feeling worried and alone

Following an adverse or traumatic experience, our brains instinctively try to make sense of what happened. It is natural for us to reflect on our own action, inaction, or judgement during this process. However, individuals with PTSD often place enormous and erroneous blame on themselves. They tend to create a strong association between their actions (or inactions) and the trauma, believing that if they had acted differently, the trauma might not have occurred. On one hand, this creates a lot of internal distress, but on the other, it creates the illusion of control which gives them a (false) sense of safety. In other words, they believe that if they can avoid the action or inaction they took during the trauma, they will be able to prevent anything bad from happening again. Thus, they develop the rule “I must not make a mistake.”


Individuals diagnosed with PTSD who develop this rule face a very difficult conflict. They believe that mistakes put them in extreme places of risk and vulnerability, thus they must avoid them at all costs. However, avoiding mistakes (even perceived ones) is impossible and therefore making mistakes is inevitable. Unable to reconcile this, people diagnosed with PTSD are often riddled with self-doubt and uncertainty. They might feel as though they are incompetent or incapable of navigating even minor stressors.


How does this rule look in real life? People with PTSD may procrastinate necessary tasks or social engagements. They may become preoccupied with how they think they “should” act or how others may view them. They may avoid trying new things despite interest out of fear of not being good enough. They may become overly self-critical or critical of others who do not align with their beliefs about what is safe or unsafe.



The Detrimental Impact of These Rules


In the aftermath of trauma, these rules might develop as a way of regaining a sense of control and safety. Though they might bring temporary feelings of relief, they actually reinforce the brain’s perception of danger and keep the nervous system in a survival state. Unfortunately, these rules perpetuate symptoms of trauma and lead to prolonged suffering.



Therapy can Help!



Feeling free

If you have experienced a traumatic event, and any of these rules resonated with you, you may benefit from therapy. Trauma Treatment can help you understand WHY your rules developed, the function they served, and how they are no longer helpful to you. In treatment, you will process your traumatic experience in a safe way so that your body can recover and return to an optimal state of arousal. In this state, you can relax without worry, you can feel energy without fear, and you can connect with others in deep and meaningful ways. Trauma treatment can help you build resources to manage the inevitable stress of life so that you can move through life freely and with pleasure.


What does recovery look like?


feeling joy

- Feeling comfortable going out for dinner

- Looking forward to attending your child’s sports game

- Feeling present in your interactions with others

- Returning to work

- Reconnecting with activities that bring you joy

- Helping you relax in the evening

- Helping you increase your productivity at home






You deserve to live a life you love. Contact us for more information on how we can help.

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